Clinical Application of Spectral Envelope Perception: Cochlear Implant Evaluation

频谱包络感知的临床应用：人工耳蜗评估

• 批准号: 9249153
• 负责人: Rene H Gifford
• 金额: $ 12.36万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-13 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9249153
• 关键词: Clinical; Application; Spectral; Envelope; Perception

9. PROJECT SUMMARY/ABSTRACT Most modern day cochlear implant (CI) candidates have residual acoustic hearing in one or both ears. Several studies have shown that this residual hearing provides significant benefit when paired with a CI in a bimodal listening configuration. The degree of acoustic-related, bimodal benefit however, varies across ears and is not correlated with audiometric threshold, etiology, age or preoperative speech recognition. In the absence of gross differences in preoperative hearing acuity, patients presenting with residual hearing in both ears are commonly told that either ear could provide benefit when paired with a CI. There is no clinical measure that provides predictive utility for selecting the ear to be implanted-a critical consideration particularly in cases for which bilateral cochlear implantation may be restricted (i.e. insurance restrictions such as encountered with Medicare and Medicaid). This application proposes to develop and implement such a clinical tool. The clinical test of spectral modulation detection (SMD) is a modified version of a validated psychophysical procedure assessing spectral resolution. In this task, the listener is asked to discriminate spectrally-flat noise from spectrally-modulated noise. Pilot work on this clinical procedure has shown SMD in the non-implanted ear is an excellent predictor of acoustic benefit (r = 0.89) when paired with a CI for bimodal hearing. Because this task contrasts noise stimuli, it does not require speech understanding and can be completed by candidates with very little residual hearing-both of which are expected for individuals being evaluated preoperatively. Pilot work with our most recent iteration of the clinical task takes 5 to 6 minutes per ear, is highly correlated with acoustic benefit in quiet and noise, and is reported as a percent correct score. This tool has the potential to satisfy a strong need in the fields of audiology and otology as well as significantly influence surgical decisions and patient outcomes. At the conclusion of this study, we will provide clinicians with a pre- and post-implant test of auditory integrity, the supporting tools to translate test scores to meaningful predictions about the potential benefit of each ear in specific treatment conditions, and a data-driven guide to ear selection. Thus, the study has the potential to help us meet the evidence-based objective in medicine in the areas of implant ear selection, expectations management, and modality selection (bimodal hearing or bilateral implantation).

9. 项目概要/摘要 大多数现代人工耳蜗 (CI) 候选者的一侧或两侧都有残余听觉 耳朵。多项研究表明，与 CI 配合使用时，这种残余听力会带来显着的好处 在双模式聆听配置中。然而，与声学相关的双峰效益的程度因人而异。 耳朵，与听力阈值、病因、年龄或术前语音识别无关。在 术前听力敏锐度不存在明显差异，患者两侧均出现残余听力 人们普遍认为，与 CI 配对时，任何一只耳朵都可以带来好处。临床上没有 为选择要植入的耳朵提供预测效用的措施——一个关键考虑因素 特别是在双侧人工耳蜗植入可能受到限制的情况下（即保险限制，例如 如医疗保险和医疗补助）。该应用程序建议开发和实施这样的 临床工具。光谱调制检测（SMD）的临床测试是经过验证的改进版本 评估光谱分辨率的心理物理学程序。在此任务中，要求听者辨别 来自频谱调制噪声的频谱平坦噪声。该临床程序的试点工作已表明 SMD 当与双峰 CI 配对时，非植入耳可以很好地预测声学效益 (r = 0.89) 听力。由于该任务对比噪声刺激，因此不需要语音理解，并且可以 由残余听力极少的候选人完成——这两项都是对于正在做准备的个人来说的 术前评估。我们最近迭代的临床任务的试点工作每次需要 5 到 6 分钟 耳朵，与安静和噪音下的声学益处高度相关，并以正确分数的百分比形式报告。 该工具有潜力满足听力学和耳科领域的强烈需求，并显着 影响手术决策和患者结果。在本研究结束时，我们将为临床医生提供 通过植入前和植入后的听觉完整性测试，将测试分数转化为有意义的支持工具 对每只耳朵在特定治疗条件下的潜在益处的预测，以及数据驱动的指南 耳朵的选择。因此，这项研究有可能帮助我们实现基于证据的医学目标 植入耳选择、期望管理和模式选择（双模听力或双边听力）领域 植入）。